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ligVA 7 <br /> BRIGHTON <br /> the city that works for you CITY OF NEW BRIGHTON <br /> 803 Old Highway 8 NW <br /> NEW BRIGHTON,MN 55112 <br /> (651)638-2050 <br /> www.newbrightonmn.gov <br /> 2013 BUSINESS LICENSE APPLICATION <br /> Applications must be completed in full. Middle initial or name is required of all parties concerned. If no middle name,please indicate by writing NMN. Sign and return <br /> application with the appropriate fee. Please advice the City of any change in status. A new license is required if a business changes location or ownership. Notification to <br /> the City of New Bri hton is required if the business closes. <br /> Business Name: X p re 5 She, y) <br /> Business Location: s 7 1/ D Id Hy g m tJ sc//Z <br /> Facility Phone: `/Z et ('F/l ? 24 hr Phone:Y or N Facility Fax: <br /> Mailing Address: g0 9 se I ID A vc <br /> (if different than above) <br /> City: S r • lock State: YY\ fU Zip: S5/U <br /> Enter Below Names of Owners,Partners or Corporate Officers-Use Additional Sheets As Necessary <br /> Ownership: jAtorporation ❑Ltd Liability Corp 0 Pn ership ❑Ltd Partnership ❑Sole Proprietor ElTrust <br /> Owner/Corp.Name: e�G i A Q Title: O W Y1 Q t/ Phone: 412�6S-,�/Is' <br /> Home Address: 01,5 I is, H,.v. v E Cell: (ol 2 S56S <br /> City: 12‘0 dh t c State: ►Nk A/ Zip:.�^S!? s--Email: 1-0 S f oI o L • Cc Inn Driver's License No. C$13 o y $16$7 f Z <br /> Minnesota Tax ID or Federal Tax ID or Social Security No. (Required) .q)t, -23 911 <br /> Owner/Corp.Name: '1-6 a 1JG S i t �N� ��qj(� Title: Phone: <br /> Home Address: Cell: _ <br /> City: State: Zip: <br /> Email: Driver's License No. <br /> Minnesota Tax ID or Federal Tax ID or Social Security No.(Required) <br /> Enter Alarm Company (if Applicable) <br /> Name: Title: <br /> Address: License No.: <br /> City: State: Zip: <br /> Flammable or Hazardous Materials Used or Stored on Premises? ❑Yes ❑No If yes,please provide list of materials&quantities <br /> Please check the License(s)for which the Application is being made. Please note the licenses are categorized by licensing period. <br /> January 1 through December 31 <br /> Equipment Rental $215.00 <br /> New Cars $215.00 <br /> Used Cars $215.00 <br /> April 1 through March 31 <br /> Amusement Center $1,750.00 <br /> Electronic Game or Device Number of games: $18.00/game <br /> Garbage&Recycler Haulers:Please check what type you service: Commercial Residential $270.00 <br /> 3.2 Percent Malt Liquor—On Sale $340.00 <br /> 3.2 Percent Malt Liquor—Off Sale $150.00 <br /> 3.2 Percent Malt Liquor—Off Sale Temporary $100.00 <br /> Drink Set-Up $425.00 <br /> Tobacco Sales $315.00 <br /> June 1 through May 31 y <br /> 0� <br /> ` GasolirlC #of Pumps �' $235.00 <br /> 30 Day Licenses <br /> Christmas Trees $85.00 <br /> /ltl <br /> 4 Total Amount Submitted $ a •— <br />